Lung transplantation using argatroban in severe heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a case series
Research article published in General thoracic and cardiovascular surgery (2020)
Abstract
Lung transplantation during heparin-induced thrombocytopenia (HIT) is controversial and often considered a contraindication because of the risk of increased bleeding and thrombosis in the recipient. Although lung transplantation offers the best chance for cure in end-stage lung disease, the outcome after transplantation is still controversial in patients with HIT. In our center, two patients developed HIT type II during venovenous extracorporeal membrane oxygenation (ECMO) support for acute respiratory failure. They underwent successful lung transplantation using argatroban. The subsequent clinical course was uneventful except evacuation of post-operative hematoma in 1 patient, and they were discharged. Argatroban was successfully used during lung transplant surgery in patients who developed HIT type II during ECMO support. Further studies on the feasibility and safety of lung transplantation using a direct thrombin inhibitor in patients with HIT during ECMO are required.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Peer-reviewed research on anticoagulant and antithrombotic agents relevant to leech-derived compounds and thrombosis management. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Esta serie de casos describe a dos pacientes que desarrollaron trombocitopenia inducida por heparin (HIT) tipo II durante el soporte con ECMO venovenosa por insuficiencia respiratoria aguda y luego se sometieron a un trasplante de pulmón exitoso anticoagulados con argatroban, un inhibidor directo de la trombina, con un curso sin complicaciones aparte de una evacuación de hematoma postoperatorio. La conexión con la historia del descubrimiento de fármacos de ASH es mecanicista: el secretoma de la sanguijuela medicinal es el origen de hirudin y los inhibidores directos de la trombina modernos, y este informe ilustra cómo la inhibición de la trombina sirve como una alternativa a heparin en cirugías de alto riesgo donde heparin está contraindicada. La advertencia es sustancial: esta es una serie de casos de dos pacientes que describe argatroban (un agente sintético), no terapia con sanguijuelas ni hirudin derivada de sanguijuelas, y los autores solicitan explícitamente más estudios sobre la viabilidad y la seguridad, por lo que solo ofrece apoyo anecdótico y generador de hipótesis para la clase de inhibidores de la trombina.
Citación
Lung transplantation using argatroban in severe heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a case series.
Lee et al. · General thoracic and cardiovascular surgery, 2020
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026